A Japanese nationwide survey on the cryopreservation of embryos, oocytes and ovarian tissue for cancer patients
A Japanese nationwide survey on the cryopreservation of embryos, oocytes and ovarian tissue for cancer patients
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DOI：
10.1111/jog.14073
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发表时间：
2019-07-30
影响因子：
1.6
通讯作者：
Osuga, Yutaka
中科院分区：
文献类型：
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作者：
Sanada, Yuko;Harada, Miyuki;Osuga, Yutaka
目的 由于肿瘤学的进步，癌症患者的生存率大大提高。保留癌症患者的生育能力是一项重要任务。为了确定癌症患者胚胎、卵母细胞和卵巢组织冷冻保存的现实，日本进行了大规模调查分析。方法 2011年1月至2015年12月期间，对613家日本妇产科学会认证的辅助生殖技术机构进行了对癌症患者进行冷冻保存的经验调查问卷。随后，向对癌症患者进行冷冻保存的机构发送了第二次调查问卷。结果 我们收到了 481 家（78.5%）机构的回复。其中，126人（26.2%）对癌症患者进行了冷冻保存。这 126 家机构收到了第二次调查问卷。其中，有 108 家（85.7%）机构做出回应。在108家机构中，为癌症患者进行了1085例胚胎或卵母细胞冷冻保存程序和122例卵巢组织冷冻保存程序。冷冻保存主要针对乳腺癌患者（约占70%），其次是血液恶性肿瘤患者。对胚胎和卵母细胞冷冻保存的患者分别进行了总共 361 个和 19 个胚胎移植周期，分别有 42 个和 7 个机构报告了接受胚胎和卵母细胞冷冻保存的患者胚胎移植后的妊娠结局。然而，7例接受卵巢组织移植的患者均未观察到妊娠。结论 不同机构之间冷冻保存的适应症、年龄限制和卵巢刺激方案存在很大差异。必须建立国家肿瘤生育登记系统来评估现有系统的安全性和有效性。
Aim The survival rates of cancer patients have greatly improved owing to the advances in oncology. The preservation of fertility in cancer patients is an important task. To determine the reality of cryopreservation of embryos, oocytes and ovarian tissue in cancer patients, large-scale survey analysis was performed in Japan. Methods We sent 613 Japan Society of Obstetrics and Gynecology-certified assisted reproductive technology institutions a questionnaire about their experience of performing cryopreservation for cancer patients between January 2011 and December 2015. Subsequently, the institutions that conducted cryopreservation for cancer patients were sent a second questionnaire. Results We received replies from 481 (78.5%) institutions. Among them, 126 (26.2%) conducted cryopreservation for cancer patients. These 126 institutions were sent a second questionnaire. Of these, 108 (85.7%) institutions responded. At the 108 institutions, 1085 embryo or oocyte cryopreservation procedures and 122 ovarian tissue cryopreservation procedures were conducted for cancer patients. Cryopreservation was mainly performed for breast cancer patients (similar to 70%), followed by patients with hematological malignancy. A total of 361 and 19 embryo transfer cycles were performed for patients whose embryos and oocytes were cryopreserved, respectively, and 42 and seven institutions reported pregnancy outcomes after embryo transfer in patients that underwent embryo and oocyte cryopreservation, respectively. However, pregnancy was not observed in the seven cases that underwent ovarian tissue transfer. Conclusion Indications, age limits and ovarian stimulation protocols for cryopreservation widely varied between the institutions. A national registration system for oncofertility must be established to evaluate the safety and efficacy of the current system.